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Fisher AP, Patronick J, Moscato EL, Gerhardt CA, Treble-Barna A, Radonovich K, Wade SL. Barriers to Care and Perceived Need for Mental Health Services Among Adolescent and Emerging Adult Survivors of Pediatric Brain Tumors. J Adolesc Young Adult Oncol 2024; 13:469-480. [PMID: 38100322 DOI: 10.1089/jayao.2023.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Purpose: Pediatric brain tumor survivors (PBTS) commonly experience mental health challenges, which can be exacerbated during adolescence and emerging adulthood (AEA). We examined survivors and caregivers' perceived need for mental health services and barriers to receiving mental health care. Methods: Families completed surveys to assess perceived need for mental health services, socioemotional impairment, and barriers to mental health services. Survivors were between 13 and 25 years of age and were at least 5 years from diagnosis. Results: Sixty-nine caregiver-PBTS dyads participated, as well as 18 survivors and 20 caregivers who participated individually. Approximately half of survivors were male (n = 57, 52.3%), 85% (n = 93) were White, and their average age was 19.31. Most caregivers (n = 63, 70.8%) and survivors (n = 55, 63.2%) endorsed need for services for the survivors. Adolescents endorsed more barriers related to perceived helpfulness, t(18) = 2.3, p = 0.03, d = 0.54, and effects of services, t(18) = 3.8, p < 0.001, d = 0.88, than their caregivers. Emerging adults, t(34) = 2.4, p = 0.02, d = 0.41, endorsed more content barriers than their caregivers.. Discussion: Both survivors and their caregivers reported obstacles to accessing mental health services such as perceived lack of need, concerns regarding the effectiveness and usefulness of services, and limited knowledge about the content of services. Psychoeducation and psychosocial screening can support families in understanding survivors' need for mental health services.
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Affiliation(s)
- Allison P Fisher
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jamie Patronick
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
| | - Emily L Moscato
- The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Cynthia A Gerhardt
- Department of Pediatrics and Psychology, The Abigail Wexner Research Institute, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, USA
| | - Amery Treble-Barna
- Neurodevelopmental Center, WVU Rockefeller Neuroscience Institute, Morgantown, West Virginia, USA
| | - Krestin Radonovich
- Physical Medicine and Rehabilitation and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Shari L Wade
- Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA
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2
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Lönnerblad M, Åberg M, Blomgren K, Berglund E. Post-Compulsory Education in Teenagers and Young Adults Treated for Brain Tumors in Childhood: A Swedish Nationwide Registry-Based Study. Cancers (Basel) 2022; 15:cancers15010255. [PMID: 36612254 PMCID: PMC9818516 DOI: 10.3390/cancers15010255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/15/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
The risk of late complications after a brain tumor in childhood is high. Both the tumor itself and the treatments give rise to sequelae that affect daily life activities. In this registry study, we explored post-compulsory education, i.e., further education following the nine compulsory years in school, in 452 cases born 1988-1996 and diagnosed with a brain tumor before their fifteenth birthday. They were compared with 2188 individual controls who were not treated for cancer. Significantly fewer teenagers and young adults treated for brain tumors in childhood attended high school or university compared with controls, especially individuals treated for embryonal tumors or optic pathway gliomas. A significantly larger proportion of subjects treated for embryonal tumors and craniopharyngiomas attended folk high schools, a type of post-compulsory school with a more accessible learning environment. For both cases and controls, we observed a positive correlation between parental education levels and attendance in high school and university. In our previous studies we have shown that children treated for brain tumors, as a group, tend to perform worse during their last year of compulsory school compared with their peers, and the current study confirms that these differences remain over time.
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Affiliation(s)
- Malin Lönnerblad
- Department of Women’s and Children’s Health, Uppsala University, Akademiska Sjukhuset, 75185 Uppsala, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 64 Stockholm, Sweden
- Department of Special Education, Stockholm University, 10691 Stockholm, Sweden
- Correspondence: ; Tel.:+46-734697279
| | - Maria Åberg
- School of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, University of Gothenburg, Sahlgrenska Academy, 40530 Gothenburg, Sweden
- Regionhälsan, Region Västra Götaland, 40583 Gothenburg, Sweden
| | - Klas Blomgren
- Department of Women’s and Children’s Health, Karolinska Institutet, 171 64 Stockholm, Sweden
- Pediatric Oncology, Karolinska University Hospital, 17164 Stockholm, Sweden
| | - Eva Berglund
- Department of Special Education, Stockholm University, 10691 Stockholm, Sweden
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3
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Trapani JA, Murdaugh DL. Processing efficiency in pediatric cancer survivors: A review and operationalization for outcomes research and clinical utility. Brain Behav 2022; 12:e2809. [PMID: 36330565 PMCID: PMC9759139 DOI: 10.1002/brb3.2809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 09/27/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Childhood cancer and cancer-related treatments disrupt brain development and maturation, placing survivors at risk for cognitive late effects. Given that assessment tools vary widely across researchers and clinicians, it has been daunting to identify distinct patterns in outcomes across diverse cancer types and to implement systematic neurocognitive screening tools. This review aims to operationalize processing efficiency skill impairment-or inefficient neural processing as measured by working memory and processing speed abilities-as a worthwhile avenue for continued study within the context of childhood cancer. METHODS A comprehensive literature review was conducted to examine the existing research on cognitive late effects and biopsychosocial risk factors in order to conceptualize processing efficiency skill trends in childhood cancer survivors. RESULTS While a frequently reported pattern of neurobiological (white matter) and cognitive (working memory and processing speed) disruption is consistent with processing efficiency skill impairment, these weaknesses have not yet been fully operationalized in this population. We offer a theoretical model that highlights the impacts of a host of biological and environmental factors on the underlying neurobiological substrates of cancer survivors that precede and may even predict long-term cognitive outcomes and functional abilities following treatment. CONCLUSION The unified construct of processing efficiency may be useful in assessing and communicating neurocognitive skills in both outcomes research and clinical practice. Deficits in processing efficiency may serve as a possible indicator of cognitive late effects and functional outcomes due to the unique relationship between processing efficiency skills and neurobiological disruption following cancer treatment. Continued research along these lines is crucial for advancing childhood cancer outcomes research and improving quality of life for survivors.
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Affiliation(s)
- Julie A Trapani
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Donna L Murdaugh
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama
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4
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Lönnerblad M, Berglund E, Åberg M, Blomgren K. Occupational outcomes after
high‐grade
or
low‐grade
brain tumors in childhood: A Swedish, nationwide,
registry‐based
study. Cancer Med 2022; 12:7459-7469. [PMID: 36419225 PMCID: PMC10067118 DOI: 10.1002/cam4.5464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Survivors of pediatric brain tumors are at high risk of late complications that may affect their daily life in both short- and long-term perspectives. METHODS In this nationwide registry-based study we explored the occupational outcomes, including employment, sickness or activity compensation and parental leave, in 452 individuals in Sweden, born 1988-1996, and diagnosed with a brain tumor before their 15th birthday. Their results were compared with 2188 matched controls. RESULTS There were significant differences between cases and controls for all assessed variables. The cases had benefitted from sickness or activity compensation 11 times more often than controls (CI 7.90-15.83; p < 0.001) between 2005 and 2016. Controls were almost three times more likely to have an employment (OR 0.36; CI 0.28-0.47; p < 0.001) and nearly twice as likely to have been on parental leave (OR 0.56; CI 0.39-0.80; p = 0.002). Although cases treated for high-grade tumors typically fared worse than those treated for low-grade tumors, significant differences for all assessed variables were also observed for cases treated for a low-grade tumor compared with controls. CONCLUSIONS Our findings emphasize the need for follow-up programs for all brain tumor diagnoses, not only those known to be at most risk. This is evident, for example, from the high number of cases who received sickness or activity compensation.
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Affiliation(s)
- Malin Lönnerblad
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Department of Special Education Stockholm University Stockholm Sweden
| | - Eva Berglund
- Department of Special Education Stockholm University Stockholm Sweden
| | - Maria Åberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Region Västra Götaland Gothenburg Sweden
| | - Klas Blomgren
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Paediatric Oncology Karolinska University Hospital Stockholm Sweden
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Rhodes A, Martin S, Toledo-Tamula MA, Loucas C, Glod J, Warren KE, Wolters PL. The neuropsychological profile of children with Diffuse Intrinsic Pontine Glioma (DIPG) before and after radiation therapy: A prospective longitudinal study. Child Neuropsychol 2022:1-25. [DOI: 10.1080/09297049.2022.2144189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Amanda Rhodes
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Staci Martin
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Mary Anne Toledo-Tamula
- Clinical Research Directorate (CRD), Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Caitlyn Loucas
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - John Glod
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Katherine E. Warren
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
- Department of Pediatric Neuro-Oncology, Dana Farber Cancer Institute/Boston Children’s Hospital, Boston, MA, USA
| | - Pamela L. Wolters
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
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Fisher AP, Patronick J, Gerhardt CA, Radonovich K, Salloum R, Wade SL. Impact of COVID-19 on adolescent and emerging adult brain tumor survivors and their parents. Pediatr Blood Cancer 2021; 68:e29116. [PMID: 34028992 PMCID: PMC8209896 DOI: 10.1002/pbc.29116] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic has prompted unprecedented challenges, contributing to greater difficulties among families of children with special health care needs, such as pediatric brain tumor survivors. We examined the impact of the pandemic on psychosocial functioning of adolescent and emerging adult survivors and their parents. We hypothesized that COVID-19 disruptions and survivor social connectedness would be associated with survivor-reported posttraumatic stress and family outcomes, including family functioning, parenting, and parent mental health. PROCEDURE Fifty-five families (44 survivors, 48 parents) were recruited via phone and email to participate in the study. Survivors were ages 13-25 (M = 19.62, SD = 3.47) and at least 5 years post diagnosis. Parents completed the COVID-19 Exposure and Family Impact Survey (CEFIS), and survivors completed the Environmental influences on Child Health Outcomes (ECHO) COVID-19 child self-report form, which assessed pandemic impacts on their psychosocial functioning. RESULTS Parents reported a mean of 7.52 (SD = 2.83) disruptions to their families' lives. The pandemic negatively affected survivors' life satisfaction (Mdiff = 0.46, t(44) = 3.96, p < .001), with 92% reporting reduced social connectedness (n = 39). Total disruptions due to COVID-19 and survivor social connectedness predicted survivor-reported posttraumatic stress, above and beyond survivors' pre-pandemic psychosocial risk. Most parents reported positive changes in their parenting (n = 31, 67.4%) and family cohesion (n = 30, 66.7%). However, they also reported worsened mood (n = 28, 62.3%) and increased anxiety (n = 31, 71.1%). CONCLUSIONS Parents and survivors reported positive and negative impacts of COVID-19, which had downstream consequences on survivor psychosocial functioning. Follow-up care should consider potential adverse effects on social connectedness and stress symptoms.
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Affiliation(s)
- Allison P. Fisher
- Division of Physical Medicine and RehabilitationCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Jamie Patronick
- Division of Physical Medicine and RehabilitationCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Cynthia A. Gerhardt
- Center for Biobehavioral HealthAbigail Wexner Research Institute at Nationwide Children's HospitalColumbusOhioUSA,Departments of Pediatrics and PsychologyThe Ohio State UniversityColumbusOhioUSA
| | - Krestin Radonovich
- Department of Physical Medicine and RehabilitationUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Ralph Salloum
- Neuro‐Oncology Program, Division of Hematology, Oncology & Bone Marrow TransplantNationwide Children's Hospital, The Ohio State UniversityColumbusOhioUSA
| | - Shari L. Wade
- Division of Physical Medicine and RehabilitationCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA,Department of PediatricsUniversity of CincinnatiCincinnatiOhioUSA
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Lönnerblad M, Berglund E, van’t Hooft I, Blomgren K. Can National Tests from the Last Year of Compulsory School Be Used to Obtain More Detailed Information about Academic Performance in Children Treated for Brain Tumours? A Nationwide, Population-Based Study from Sweden. Cancers (Basel) 2021; 13:cancers13010135. [PMID: 33406638 PMCID: PMC7795235 DOI: 10.3390/cancers13010135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/22/2020] [Accepted: 12/25/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Children treated for brain tumours often suffer from late-appearing complications, including impaired cognitive performance. In this study, 475 Swedish children diagnosed with a brain tumour before their 15th birthday and 2197 matched controls were included. Data from compulsory national tests performed school year nine in the first foreign language English, the mother tongue Swedish and mathematics were analysed. These tests offered more detailed information on academic strengths and weaknesses than the final grades, as different skill sets were assessed. Cases performed worse than controls in English tests than in Swedish and mathematics tests, and they may have performed better in oral than written tasks. There were larger differences between girls treated for brain tumours and their female controls than between boys treated for brain tumours and their male controls. National tests may be useful to complement neuropsychological follow-ups. Characterising these shortcomings is essential to provide appropriate support and prevent social isolation. Abstract Children treated for brain tumours often have late-appearing complications that may affect their school performance. Uneven skill profiles may help reveal late complications that can be compensated for but otherwise remain undetected. We investigated Swedish national school tests of oral, reading and writing skills in the first foreign language (English), the mother tongue (Swedish) and mathematics. Data were obtained from The Swedish Childhood Cancer Registry and Statistics Sweden. The results from 475 children diagnosed with a brain tumour before their 15th birthday and 2197 matched controls showed that children treated for brain tumours evinced more difficulties with national tests than controls in almost all subtests, especially in the subject English, and that they may perform better on oral than written tasks. There were larger differences between female cases and controls than between male cases and controls; age at diagnosis played a significant role for some subtests, whereas tumour grade did not. Missing information from national tests proved to be a strong predictor of poor academic performance. Our results show that regular educational follow-ups, as a complement to neuropsychological follow-ups, are important for all children treated for brain tumours, regardless of sex, age at diagnosis or tumour grade.
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Affiliation(s)
- Malin Lönnerblad
- Department of Special Education, Stockholm University, 106 91 Stockholm, Sweden;
- Department of Women’s and Children’s Health, Karolinska Institutet, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden;
- Correspondence: (M.L.); (K.B.)
| | - Eva Berglund
- Department of Special Education, Stockholm University, 106 91 Stockholm, Sweden;
| | - Ingrid van’t Hooft
- Department of Women’s and Children’s Health, Karolinska Institutet, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden;
| | - Klas Blomgren
- Department of Women’s and Children’s Health, Karolinska Institutet, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden;
- Paediatric Oncology, Karolinska University Hospital, J9:30, 171 64 Stockholm, Sweden
- Correspondence: (M.L.); (K.B.)
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8
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Bourque CJ, Bonanno M, Dumont É, Gaucher N, Lacoste-Julien A, Gomez-Tyo M, Langlet MF, Sultan S. The Integration of Resource Patients in Collaborative Research: A Mixed Method Assessment of the Nesting Dolls Design. PATIENT EDUCATION AND COUNSELING 2020; 103:1830-1838. [PMID: 32418681 DOI: 10.1016/j.pec.2020.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 04/08/2020] [Accepted: 04/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES This is a quality assessment of a research design developed for a collaborative study on adolescents and young adults who survived a brain tumor. METHODS A descriptive and critical mixed methods approach was used to assess the design itself, the quality and information power of the database and the integration of collaborators. Project documentation, field notes and transcripts from focus groups interviews(n = 19) were used for the evaluation, which was based on the Consolidated Criteria for Reporting Qualitative Research. RESULTS The design proved to be pertinent to resolve methodological stakes in a "fragile field". The mobilisation of collaborators as members of a "Sherpa team" in all phases of the project helped the team create a progressive focus approach well-adapted for data gathering and analysis as well as produce a high-quality database. CONCLUSION The Nesting Dolls Design including the didactic approach developed along the deployment of the project helped researchers, clinicians and resource patients/parents understand the research procedures and the roles of all collaborators. This fostered a meaningful engagement in the project. PRACTICE IMPLICATIONS Resources and time for training, communication and supervision are necessary to reach the objectives of collaborative research involving novices and are worth the time and efforts.
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Affiliation(s)
- Claude Julie Bourque
- Sainte-Justine University Hospital (CHUSJ) Research Center, Department of Pediatrics, University of Montréal, Montréal, Canada.
| | - Marco Bonanno
- Division of Hematology-Oncology, Sainte-Justine University Hospital, Montréal, Canada
| | - Émilie Dumont
- Department of Psychology, University of Montréal, Montréal, Canada
| | - Nathalie Gaucher
- Department of Pediatrics, University of Montréal, Division of Emergency Medicine, Sainte-Justine University Hospital, Montréal, Canada
| | | | - Mathias Gomez-Tyo
- Leucan (Québec association for parents of children with cancer), Montréal, Canada
| | - Marie-France Langlet
- Patients-Families-Providers Partnership Office, Sainte-Justine University Hospital, Montréal, Canada
| | - Serge Sultan
- Psycho-Oncology Center, Sainte-Justine University Hospital, Montréal, Canada
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9
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Lönnerblad M, Van't Hooft I, Blomgren K, Berglund E. A nationwide, population-based study of school grades, delayed graduation, and qualification for school years 10-12, in children with brain tumors in Sweden. Pediatr Blood Cancer 2020; 67:e28014. [PMID: 31595683 DOI: 10.1002/pbc.28014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 08/28/2019] [Accepted: 09/06/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND As many as 95.7% of children diagnosed with a brain tumor will experience persistent late effects as adults. These include difficulties with general executive functions, lower IQ, and mental fatigue, which may negatively affect school performance. METHODS Through the Swedish Childhood Cancer Registry, we identified 475 children born between 1988 and 1996, diagnosed with a brain tumor before their 15th birthday. School grades in "Swedish," "mathematics," and "English," if their graduation was delayed, and qualification for school years 10-12 were compared with 2197 matched controls. Furthermore, we checked for interaction effects between sex and age at diagnosis, and possible effects of tumor grade (high or low) as well as parents' education. RESULTS Children treated for a brain tumor performed worse in the subjects compared to controls and also had delayed graduation to a greater extent. Fewer children treated for a brain tumor than controls qualified for school years 10-12. Children treated at a young age, especially females, and children whose parents have low education seem to be at particular risk. Unexpectedly, there were no differences in outcomes between survivors with high- and low-grade tumors. CONCLUSIONS It is important that schools provide regular pedagogical assessment and individualized support to meet the different needs of children treated for a brain tumor. Children treated for low-grade tumors do not perform better than children treated for high-grade tumors, despite the lighter treatment, and hence require the same attention and support.
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Affiliation(s)
- Malin Lönnerblad
- Department of Special Education, Stockholm University, Stockholm, Sweden.,Neuropediatric Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Van't Hooft
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Klas Blomgren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Pediatric Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Berglund
- Department of Special Education, Stockholm University, Stockholm, Sweden
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10
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Jacobson LA, Mahone EM, Yeates KO, Ris MD. Processing speed in children treated for brain tumors: effects of radiation therapy and age. Child Neuropsychol 2018; 25:217-231. [PMID: 29621934 DOI: 10.1080/09297049.2018.1456517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The current study examined processing speed in children two years post-treatment for brain tumors (BT) with radiation therapy (RT) compared to those treated with without RT. Participants included 59 children (4-17 years) with BT assessed as part of the Brain Radiation Investigative Study Consortium (BRISC). Processing speed was assessed at two time points: Time1 (3-9 months post-surgery) for 26 children who received whole brain or focal RT (RT group) and 33 treated without RT (no-RT group), and again two years later (Time2) for 42 participants (17 RT, 25 no-RT). Linear mixed effects (LME) regression analyses examined differences in cognitive and motor speed between groups and across visits, with age at Time1 (age1) treated as a moderating variable, and sex and primary tumor size as covariates. No effects for treatment group or visit were found for motor speed (Pegboard) or mean reaction time (Attention Network Task). On the Wechsler Processing Speed Index (PSI), the no-RT group performed better than the RT group, with a group-by-age interaction such that across visits, the difference between the no-RT and RT groups was larger among children who were older at initial treatment (≥10 years) than among those who were younger (<10 years). Cumulative brain injury earlier in life (tumor, surgery, plus RT) may result in greater impact on more complex tasks of cognitive efficiency. Children receiving RT showed reduced processing speed over time, with a larger group difference among those who were over 10 years at treatment.
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Affiliation(s)
- Lisa A Jacobson
- a Department of Neuropsychology , Kennedy Krieger Institute , Baltimore , MD , USA.,b Department of Neuropsychology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - E Mark Mahone
- a Department of Neuropsychology , Kennedy Krieger Institute , Baltimore , MD , USA.,b Department of Neuropsychology , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Keith O Yeates
- c Department of Psychology, Alberta Children's Hospital Research Institute, and Hotchkiss Brain Institute , University of Calgary , Calgary , Canada
| | - M Douglas Ris
- d Department of Pediatrics, Section of Psychology , Texas Children's Hospital , Houston , TX , USA.,e Department of Pediatrics, Section of Psychology , Baylor College of Medicine , Houston , TX , USA
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11
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de Vries M, de Ruiter MA, Oostrom KJ, Schouten-Van Meeteren AYN, Maurice-Stam H, Oosterlaan J, Grootenhuis MA. The association between the behavior rating inventory of executive functioning and cognitive testing in children diagnosed with a brain tumor. Child Neuropsychol 2017; 24:844-858. [PMID: 28693404 DOI: 10.1080/09297049.2017.1350262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Pediatric brain tumor survivors (PBTS) suffer from cognitive late effects, such as deteriorating executive functioning (EF). We explored the suitability of the Behavior Rating Inventory of Executive Function (BRIEF) to screen for these late effects. We assessed the relationship between the BRIEF and EF tasks, and between the BRIEF-Parent and BRIEF-Teacher, and we explored the clinical utility. Eighty-two PBTS (8-18 years) were assessed with EF tasks measuring attention, cognitive flexibility, inhibition, visual-, and working memory (WM), and with the BRIEF-Parent and BRIEF-Teacher. Pearson's correlations between the BRIEF and EF tasks, and between the BRIEF-Parent and BRIEF-Teacher were calculated. The BRIEF-Parent related poorly to EF tasks (rs < .26, ps > .01), but of the BRIEF-Teacher the WM-scale, Monitor-scale, Behavioral-Regulation-Index, and Meta-cognition-Index, and Total-score (rs > .31, ps < .01) related significantly to some EF tasks. When controlling for age, only the WM scale and Total score related significantly to the attention task (ps < .01). The inhibit scales of the BRIEF-Parent and BRIEF-Teacher correlated significantly (r = .33, p < .01). Children with clinically elevated scores on BRIEF scales that correlated with EF tasks performed worse on all EF tasks (ds 0.56-1.23, ps < .05). The BRIEF-Teacher Total and Index scores might better screen general EF in PBTS than the BRIEF-Parent. However, the BRIEF-Teacher is also not specific enough to capture separate EFs. Solely relying on the BRIEF as a screening measure of EFs in BPTS is insufficient. Questionnaires and tasks give distinctive, valuable information.
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Affiliation(s)
- M de Vries
- a Research Priority Area Yield , University of Amsterdam, Amsterdam, The Netherlands.,b University of Nottingham - Malaysia Campus, School of Psychology, Semenyih, Selangor, Malaysia.,c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands.,d Department of Medical Psychology, VU University Medical Center , Amsterdam, The Netherlands
| | - M A de Ruiter
- c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands
| | - K J Oostrom
- c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands.,d Department of Medical Psychology, VU University Medical Center , Amsterdam, The Netherlands
| | | | - H Maurice-Stam
- c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands
| | - J Oosterlaan
- f Emma Children's Hospital, AMC, Amsterdam , The Netherlands.,g Department of Clinical Neuropsychology, VU University , Amsterdam, The Netherlands
| | - M A Grootenhuis
- c Emma Children's Hospital, AMC, Psychosocial Department, Amsterdam, The Netherlands.,h Princess Maxima Center for pediatric oncology, Utrecht, The Netherlands
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